Long-term continuous temperature monitoring at a community cancer center: Towards a new standard of care in oncology.

Abstract

e13883 Background: The standard of care for fever detection in oncology relies on oral thermometer measurements, which contributes to delayed detection of complications due to episodic measurement and non-compliance. Remote patient monitoring (RPM) with a wearable thermometer would enable earlier detection; however, there remains uncertainty around reimbursement policies and the feasibility of deployment at community medical centers. To address these concerns, this study developed an RPM program at a community oncology hospital based on the AION TempShield™, a wearable thermometer that transmits continuous body temperature to a web portal. Methods: Patients starting chemotherapy were enrolled for up to six months of RPM. Fever alerts were configured to trigger if the temperature exceeded 100.4°F for one hour during the day or three hours at night. Measurement accuracy was assessed by comparison to oral thermometer readings. A comparison of acute care utilization and mortality rates between RPM-compliant participants and those that were non-compliant or declined RPM was used to assess clinical effectiveness; compliance was defined as wearing the TempShield for at least one hour for more than 50% of outpatient days. Economic impact and patient satisfaction were evaluated through tabulation of billable CPT code claims and surveys, respectively. Results: Of 123 participants, 85 were compliant and 38 were non-compliant; an additional 15 participants declined RPM but agreed to be part of the comparator. Compliant participants were retained for an average of 120 days and wore the device for 85% of days, averaging 18 hours of wear per day. Overall, TempShield measurements showed concordance with the oral thermometer, with a mean difference of 0.2°F (95% limits of agreement from -1.0°F to 1.4°F). Compared to the non-compliant participants, the compliant cohort showed a significant reduction in mean inpatient days over a 30-day exposure (1.43 to 0.31; p < 1e-04) and 60-day mortality (15.1% to 1.2%; p = 0.008). CPT claims were successfully generated, with 71% of enrolled participants meeting the criteria for CPT 99453 (device setup) and 311 claims generated for CPT 99454 (data transmission). Overall, reimbursement through insurance was approved for 99% of participants, with an average copay of $15 and 54% incurring no out-of-pocket cost. Satisfaction surveys indicated that 98% of participants would recommend the device, with 69% experiencing increased peace of mind. Conclusions: Compliance with long-term temperature monitoring was associated with significantly improved outcomes. The program achieved favorable reimbursement rates and was highly rated by patients. While future studies would be beneficial, this work demonstrates that remote monitoring with TempShield can be successfully deployed at a community cancer center, marking a significant step toward a new standard of care in oncology.